Opportunity Information: Apply for 72068718RFA00004
The Accessible Continuum of Care and Essential Services Sustained (ACCESS) Program in Madagascar is a USAID/Madagascar funding opportunity aimed at improving the country health system so it can consistently deliver quality essential health services for both rural and urban communities. USAID is soliciting applications for a Cooperative Agreement, meaning the awardee would implement the program in close collaboration with USAID rather than operating completely independently. The activity is designed to support USAID/Madagascar five-year Health Development Objective for 2016-2020, described as accelerating sustainable health impacts for Malagasy people, and it builds directly on lessons and approaches from prior USAID-supported efforts in Madagascar, including Mikolo, MAHEFA, Mahefa Miaraka, and the Maternal and Child Survival Program (MCSP).
At the core of ACCESS is the idea of strengthening the full service delivery continuum, from community-level prevention and referral all the way to care at higher-level facilities. The program targets three main tiers of the system: community health volunteers (CHVs) who serve as a frontline link to households, primary health facilities known as Centres de Sante de Base (CSBs), and district hospitals that provide more advanced services and supervision. USAID intends for ACCESS to improve both clinical and non-clinical capacity, which typically includes upgrading provider competencies and clinical practice while also addressing operational issues that affect quality, such as supervision, patient flow, data use, logistics, and management at facility and district levels. A major emphasis is placed on strengthening district-level health systems and structures below the district, reflecting a focus on practical service delivery improvements where most routine care is organized and monitored.
ACCESS also includes a strong coordination and governance component. The activity will engage regional health authorities so that planning, oversight, and implementation across districts are coordinated and managed effectively. This suggests the program is not only about delivering services or trainings, but also about improving how health activities are organized, tracked, and harmonized across the public system to reduce fragmentation and improve accountability. In addition, there is a national-level focus on developing in-service training curricula for health providers and establishing performance improvement and quality assurance measures. In practice, this points to standardizing training content, reinforcing ongoing professional development, and putting in place systems that help facilities measure quality and continuously improve, rather than relying on one-off trainings.
Another key pillar is social and behavior change. ACCESS aims to develop healthier community norms and encourage health-seeking behaviors, alongside building the capacity of Malagasy institutions to lead and coordinate these behavior change efforts. This component recognizes that better services alone are not sufficient if people are not aware of, motivated to use, or able to access care. Strengthening local leadership for social and behavior change also indicates an intent to make demand generation more sustainable by placing responsibility and expertise within Malagasy organizations rather than relying indefinitely on external implementers.
Administratively, the opportunity is listed as discretionary funding and falls under the health category, with CFDA number 98.001. The funding opportunity number is 72068718RFA00004. Eligibility is described as unrestricted, meaning both U.S. and non-U.S. organizations may apply, although applicants are still expected to meet the specific eligibility conditions described in Section C of the Notice of Funding Opportunity (NOFO). USAID anticipated making one award, with an award ceiling of $90,000,000. The opportunity was posted on February 27, 2018, with an original closing date of April 19, 2018, under USAID Mission to Madagascar (USAID-Antananarivo).Apply for 72068718RFA00004
- The Agency for International Development, Madagascar USAID-Antananarivo in the health sector is offering a public funding opportunity titled "Accessible Continuum of Care and Essential Services Sustained (ACCESS) Program in Madagascar" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 98.001.
- This funding opportunity was created on Feb 27, 2018.
- Applicants must submit their applications by Apr 19, 2018. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- Each selected applicant is eligible to receive up to $90,000,000.00 in funding.
- The number of recipients for this funding is limited to 1 candidate(s).
- Eligible applicants include: Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled Additional Information on Eligibility.
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